Environmental risk factors for acute respiratory distress syndrome

Clin Chest Med. 2014 Dec;35(4):625-37. doi: 10.1016/j.ccm.2014.08.003. Epub 2014 Sep 30.


Acute respiratory distress syndrome (ARDS) remains a major cause of morbidity and mortality in critically ill patients. Over the past several decades, alcohol abuse and cigarette smoke exposure have been identified as risk factors for the development of ARDS. The mechanisms underlying these relationships are complex and remain under investigation but are thought to involve pulmonary immune impairment and alveolar epithelial and endothelial dysfunction. This review summarizes the epidemiologic data supporting links between these exposures and ARDS susceptibility and outcomes and highlights key mechanistic investigations that provide insight into the pathways by which each exposure is linked to ARDS.

Keywords: Acute respiratory distress syndrome; Alcohol abuse; Cigarette smoking; Epidemiology; Future interventions; Mechanisms; Modifiable risk factors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alcoholism / complications
  • Environmental Exposure / adverse effects
  • Humans
  • Respiratory Distress Syndrome / epidemiology*
  • Respiratory Distress Syndrome / etiology
  • Risk Factors
  • Smoking / adverse effects